Biomedical Beliefs Explain the Clinical Decisions Made by Exercise-Based Practitioners for People With Chronic Low...

Area of Science:

• Musculoskeletal Rehabilitation
• Pain Management
• Clinical Psychology

Background:

• Limited research exists on accredited exercise physiologists' (AEPs) attitudes towards chronic low back pain (CLBP).
• Physiotherapist literature indicates a tendency towards biomedical approaches, potentially resulting in conservative treatments that may contradict practice guidelines.

Purpose of the Study:

• To survey attitudes and beliefs of Australian physiotherapists and AEPs regarding CLBP.
• To investigate how biomedical and biopsychosocial beliefs impact clinical decision-making in exercise-based practitioners treating CLBP.

Main Methods:

• A cross-sectional survey design was employed.
• 75 AEPs and 75 physiotherapists completed the Pain Attitudes and Beliefs Scale (biomedical and biopsychosocial subscales).
• Clinical decision-making was assessed using two patient vignettes.

Main Results:

• AEPs reported significantly higher biomedical beliefs than physiotherapists.
• No significant differences were found between groups for biopsychosocial beliefs.
• Biomedical beliefs positively correlated with more conservative clinical decision-making, irrespective of professional background.

Conclusions:

• Biomedical beliefs regarding CLBP influence clinical decision-making across professions, favoring conservative approaches.
• Higher biomedical scores in AEPs suggest a greater likelihood of conservative care, potentially leading to patient care inconsistencies.
• Education on the biopsychosocial model is crucial for exercise practitioners to align with clinical guidelines and improve CLBP management.